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Midwife charged in DC? Karen Carr, CPM...
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Anonymous
But the head became entrapped, which is a significant risk in breech deliveries. He wasn't struck by lightning, this wasn't an Act of God. That death was preventable by c-section delivery. It, like all surgery, would have posed some risk to the mom but would have minimized the risk of entrapment to the baby. It's is so sad that Tchabo was out of town, although they might have ultimately risked out with him too. It sounds to me like Birth Care might have referred them to Tchabo and someone else referred them to homebirth midwives who would deliver breech babies. According to the Post article or Fox story, no one in VA would take her on as a client which is how she ended up with Karen. I wish that someone had helped them process their feelings about the change in delivery plan and they had just gone ahead with a hospital delivery. If they were at AHC the delivery may even have coincided with Tchabo being available. I was in that mom's shoes and did opt for a c-section after risking out with Tchabo. My midwives were very supportive but clear that he was the only safe option besides a c-section due to my baby's breech presentation. When he shifted to footling, they and Tchabo, were unanimous that it was not safe to deliver vaginally. |
Anonymous
I said it before and I'll say it again. Sometimes parents are not just chasing a birthing in the rain type fantasy where they imagine a perfect beautiful birth. There were risks on every side of their decision - it's not like csection is totally without risk either. There are risks at the time if the csection, risks afterwards, risks to baby such as breastfeeding potetially not going as well, risks for subsequent pregnancies, etc. It's not quite as simple as you put it. |
Anonymous
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As others have said, it is not e'ffing about you and the memories of a perfect, zen-like birth. It is about minimizing risk to another human being -- your own flesh and blood.
Please stop being so selfish. Flame away. |
Anonymous
And it's not so complicated as you'd like to make it out either. The risks of the c-section are mainly to the mother but are far less than the risk of entrapment with these factors, estimated at 8-10% upthread. Sadly 100% here. I breastfed each of my kids for 3 years, one was a vaginal birth, one was a c-section and one was a VBAC. I'd pick formula over a dead baby in a heartbeat. The mom was 43, doubt that there were or are many subsequent pregnancies in the cards for her. So sad. |
Anonymous
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23:27 makes the important point so many have failed to grasp. For some people especially surgery of any type is very Risky. The assumption that cs was the less Risky option indicates that there has been some Kool-ade drinking. You do not understand the mothers medical history. No one thinks a home breech birth is going to be ideal. This was not some foolish activis sacrificing her childs welfare for some romantic birth fantasy. I don't think that happens it's like the welfare queen myth. Parents who have their babies at home do so for the same reasons that pArents who expose themselves to the risks of hospital births make their choice. They are acting in the best interests of their family.
I left an ob practice to have an unmedicated birth at a birth center with midwives and it was by far the best decision for my family. I have a very challenging baby and if I had needed the same recovery time as my friends who had medical births my little one would have suffered while I was recovering and unable to give her the care she needed. I know many women who have regrets about their hospital births and feel that it was not good for their babies. The console themselves by saying "at least he / she is alive" but is that really what we want as a society mothers and babies that survive their births with regrets and long recovery times. Is that what you want for your daughters and sons. I think that we should be able to decide for ourselves what is best for our families. Surviving a horrible birth to struggle to recover while caring for a newborn who is "at least alive" is not something I would impose on anyone and it is not something I would have imposed on me. |
Anonymous
You undercut your own point here. If your baby is dead you have no "family" and no newborn to care for. If the mother's medical history made a c-section genuinely riskier that is even sadder but that isn't the point you make above. One thing I do get from your post is the whole issue of "imposing" or being "imposed on". It seems to me that control over the birth environment is paramount to home birthers rather than focusing on the product of the birth, the safe baby. "At least alive" is the be all and end all for most people. |
Anonymous
I am SO tired of the repeated assumption running throughout this entire thread that the baby would have survived a c/s. No, the risk of a c/s does NOT pertain only to the mother. Babies can and do die as a direct result of a c/s. My second child was in the breech position when I went into labor. While I did (and still do) believe that a vaginal birth is a viable option for a breech presenting baby, I also would never trust any care provider (OB or otherwise) who does not have vaginal breech birth training and experience. As my OB at the time did not, I agreed to a c/s. Unfortunately, while being extracted from my uterus, my baby's head became *entrapped*. After several minutes, the OB finally had to slice my uterus vertically in order to free my baby. He was blue and lifeless. An entrapped head can happen in BOTH a vaginal and a c/s birth. The myth that a c/s is always the safe alternative to a vaginal birth for a breech presenting baby is just that...a myth. I've had 2 c/s for breech presentation....not once did any OB ever mention this as a possibility. Thankfully, my son survived. However, had he not, I doubt any police would have shown up to arrest the OB despite the fact that this injuries were a *direct* result of the c/s which had been essentially forced/coerced (I've left out many details leading up to the c/s). It wouldn't have mattered that the OB had less experience than Karen. It wouldn't have mattered that both situations are perfectly *legal* under VA law. Really, enough with the falsehood that a c/s would have guaranteed a different outcome. |
Anonymous
No, the police would not have arrested your OB because he was acting according to best medical practice and with a license. If your son had had a bad outcome, however, you could have sued your OB for a million dollars in a civil suit. Happens all the time in OB. No one thinks that CS guarantees any outcome. That's black and white thinking on your part, to suggest that since some babies are injured in CS, then CS is no "guarantee" of a different outcome. A vaginal breech delivery has a head entrapment rate of ~8% and a neonatal mortality/severe morbidity rate of ~2.5-5%. On the other hand, the rate for major birth trauma in a planned CS is ~0.1%. So no, a CS wouldn't have guaranteed a different outcome. There are no guarantees. But the risks of CS are clearly much lower than the risks of vaginal birth for the baby in that situation, and arguing otherwise is misrepresenting the truth. |
Anonymous
Actually, the current medical policy of an auto c/s for breech is based on a now debunked study. It my be a widely practiced policy but it is NOT a "best medical practice". As for the license issue...I'm personally more concerned with training and experience than with a piece of paper given out by a politically influenced organization. Further, it is not black and white thinking on my part that a c/s is no guarantee...it's a fact (as even you stated in your final paragraph). If some babies are injured due to a c/s, it logically follows that a c/s is no guarantee. I'm guessing you are pulling your stats from the Term Breech Trial which, as previously mentioned, has been shown to be bad science? Later studies have shown that vaginal breech birth, despite your assertion, is a safe option. And yes...there is definitely a theme here that the baby in this case would still be alive today had the parents only agreed to a c/s. It is simply a false premise. |
Anonymous
As I understand it, the current medical standard of care for breech presentation is to counsel the mother that the risks of neonatal mortality and morbidity are increased, but that it certainly isn't an auto CS. Of course, many individual physicians will choose to not attend vaginal breech births when possible because they are associated with higher risks to the baby, which translates to more bad outcomes, which translates to more risk (both legally and morally) assumed by the care provider. I have read the Term Breech Trial, and it's definitely not "bad science." It's the biggest study of its kind, and while it has many drawbacks, it is also useful in the context of the bigger research picture. The study I was thinking about was actually the California population-based study. It found that with primips delivering breech babies, the neonatal mortality rate was ~0.2% and the rate of brachial plexus injury was ~0.9%. Babies delivered vaginally also had much-increased rates of asphyxia, birth trauma, and need for continuous mechanical ventilation as compared to the CS group. In this study, the neonatal mortality for women who had previously delivered vaginally was much better than the primips' rate, but those babies still had increased rates of injuries. I think this baby had a much better shot at living with a CS than being delivered vaginally far away from CS and/or someone who could administer nitro and do Duhrssen incisions. But of course, no guarantees. As for the studies I've looked at, there are also large Dutch and Swedish studies that found that neonatal mortality/morbidity is increased with vaginal breech birth. There is one large French study that found little or no difference between CS and vaginal delivery for breech birth, and a couple of pretty small studies, but at the moment the majority of the evidence suggests that vaginal breech deliveries, especially for primips, are more risky for the baby than CS. Of course, the question of the risks of CS on mothers is a whole different question, and every woman should be able to make that choice for herself. However, I do see a lot of CS scare-mongering on some of the more "natural childbirth" kind of boards, and I wonder if that attitude is distorting the actual risks of CS for some moms. But that's a whole different conversation. |
Anonymous
I don't think its a myth. I know lots of pro home birthers and many of them are caught up with romantic notions. They get very swept up. I have nothing against home birth, in fact, I find the idea of unassisted home birth ok also but in a case where there are medical professionals telling you there is a serious risk if you proceed, then to go forward seems quite reckless. If surgery was not truly an option ever, then maybe pregnancy should not have been an option ever as there is always a chance you might need surgery to give birth (c-section). Also, yes, surgery is risky, but at least in a hospital setting they will be trying as hard as they can do everything to make sure the mom and baby live. |
Anonymous
| After lurking on the Joyous Birth/Mothering websites, I am starting to wonder if the homebirth population has a higher rate of abuse survivors than the general population. I feel like I am seeing some themes and trends and am wondering if that might be an area of study for some enterprising scientist. |
Anonymous
I'm sure this type does exist. But I also know lots of home birth and birth center birth people and they are some of the most practical, straightforward, no-nonsense people I have ever known. They are all highly educated and know a lot about birth. One of them is married to a doctor who supports her wholeheartedly. One of them is a nurse practitioner who had 4 babies at home. All of them go to the doctor when they are sick and need medical care. I never heard even one of the home birthers I know say one romanticized thing about giving birth. They generally talk about birth the same way other women do- much like the way military men share war stories. It's generally a lot about pain and gory details. They are fully aware that birth is not that pretty. I had a baby in freestanding birth center and, frankly, I hated giving birth. HATED it. I never thought I would love it either- I just knew I was less likely to be poked and prodded and injected and messed with if I stayed out of the hospital. That said, I would not have tried a breech birth outside the hospital and I would not have hired a CPM. But I do support the right of women to do so. |
Anonymous
I disagree. She stated as fact that this birth assistant attends extremely high risk births with no regard for the dangers. That cannot be called opinion and could definitely be proven to be a lie. Unless she has actual proof, which I doubt since clearly the person she named did not attend her own birth, this could be considered defamation of character. |
Anonymous
Totally agree - I do not know anyone who chose a midwife assisted birth because they wanted the perfect birth. For everyone I know, myself included, it was about doing the safest thing for my child and for me. And yes believe it or not, my child was first on my list. Though I may personally disagree with some of her choices, I hate that people are blaming the mother here, or assuming her decision was about wanting the perfect birth over a safe child. Babies die or are injured because of doctor errors in hospitals on a regular basis, yet no one blames those mothers for not choosing midwife care which may have been better. |